Nagel M, Ockert D, Stoelben E, Saeger H D
Chirurgische Universitätsklinik Mannheim.
Zentralbl Chir. 1994;119(7):488-94.
Between 1.1.1973 and 30.6. 1993 57 patients underwent operation for soft-tissue sarcoma of the retroperitoneum. The histological classification showed in 21 cases a liposarcoma and in 14 cases a leiomyosarcoma. Other histological types like fibrosarcoma, malignant fibrous histiocytoma or malignant schwannoma were only rarely seen. Complete resection (R-0-resection) was possible in 39 cases (73.5%). 6 patients underwent partial resection (R-2-resection) and 8 patients had only an explorative laparotomy because of an unresectable tumor. To realize a complete resection in 23 cases a multivisceral resection was necessary. The postoperative staging according to AJCC showed for 47.7% of the patients a stage III- or stage IV- disease. The clinical follow-up was observed between 3 months and 14.3 years. The cumulative 5-year-survival-rate for all patients was 38.2%. The most important factor for prognosis was the complete resection, while other factors like sex and age of patients, size of the tumor and histological type did not predict outcome. After complete resection the cumulative 5-year-survival-rate was 46.7%, while after partial resection or explorative laparotomy no patient survived 5 years.
1973年1月1日至1993年6月30日期间,57例患者接受了腹膜后软组织肉瘤手术。组织学分类显示,21例为脂肪肉瘤,14例为平滑肌肉瘤。其他组织学类型如纤维肉瘤、恶性纤维组织细胞瘤或恶性神经鞘瘤则很少见。39例(73.5%)患者可行根治性切除(R-0切除)。6例患者接受了部分切除(R-2切除),8例患者因肿瘤无法切除仅行了探查性剖腹术。为实现23例患者的根治性切除,需要进行多脏器切除。根据美国癌症联合委员会(AJCC)的术后分期,47.7%的患者为Ⅲ期或Ⅳ期疾病。临床随访时间为3个月至14.3年。所有患者的5年累积生存率为38.2%。预后的最重要因素是根治性切除,而患者的性别、年龄、肿瘤大小和组织学类型等其他因素并不能预测预后。根治性切除后的5年累积生存率为46.7%,而部分切除或探查性剖腹术后无患者存活5年。